Key result
Concomitant tricuspid valve repair during pulmonary valve replacement in repaired tetralogy of Fallot was associated with less frequent normal tricuspid valve coaptation (52.6% vs. 93.1%, p<.001).
Why the study?
To investigate the outcomes of tricuspid valve repair performed concomitantly with pulmonary valve replacement in repaired tetralogy of Fallot patients.
Does concomitant tricuspid valve repair improve tricuspid regurgitation in patients undergoing pulmonary valve replacement after tetralogy of Fallot correction?
Cohort (n=38)
Does concomitant tricuspid valve repair improve tricuspid regurgitation in patients undergoing pulmonary valve replacement after tetralogy of Fallot correction?
Absolute Event Rate: 52.6% vs 93.1%
p-value: p=<.001
Concomitant tricuspid valve repair during pulmonary valve replacement in repaired tetralogy of Fallot significantly decreases tricuspid regurgitation, though abnormal coaptations are more frequent in these patients.
TVR linked to less normal coaptation may reflect case selection; leaves open whether repair improves outcomes in repaired TOF.
Objectives: We aimed to investigate the outcome of tricuspid valve repair (TVR) performed concomitantly with pulmonary valve replacement in repaired tetralogy of Fallot (TOF) patients. Design: This retrospective study included all patients who underwent pulmonary vale replacement from 2000 to 2016 after TOF correction. TVR patient data were compared to those of patients who underwent pulmonary vale replacement alone. Results: Thirty-eight patients were enrolled. The degree of tricuspid regurgitation was significantly decreased after operation in the TVR group. Tricuspid valve annulus and annuloectasia before operation did not vary between groups (21.1 ± 6.3 and 41.4% in no TVR vs. 21.3 ± 4.8 and 52.6% in TVR). However pre-operative right ventricular volumes were larger in the TVR group. Normal tricuspid valve coaptation (body to body) was observed less frequently in the TVR group than in the other group (52.6% vs. 93.1%, p < .001). Pre-operative tricuspid regurgitation had a linear correlation with right ventricular volume, but not with tricuspid annulus size. Conclusion: Tricuspid annulus diameter decreased significantly regardless of TVR. Abnormal coaptations were observed more in patients group and the degree of pre-operative tricuspid regurgitation was linearly correlated with right ventricular volume rather than tricuspid annulus size.
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Kim et al. (2019) conducted a cohort in Repaired tetralogy of Fallot (n=38). Tricuspid valve repair concomitantly with pulmonary valve replacement vs. Pulmonary valve replacement alone was evaluated on Normal tricuspid valve coaptation (p=<.001). Concomitant tricuspid valve repair during pulmonary valve replacement in repaired tetralogy of Fallot was associated with less frequent normal tricuspid valve coaptation (52.6% vs. 93.1%, p<.001).
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